NPI age
19 years
Enumerated 2006-07-20
Across 7055 active pediatrics providers in Texas.
11 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 742085274 | TAXPAYER IDENTIFICATION |
| 05 (TX) | 126915106 | |
| 05 (TX) | 126915102 |
Part of a multi-provider practice. 25 other active providers share this practice address in NPPES.
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